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Biomedical subjects

E Leino

Publications and source records attributed to E Leino.

At least 19 recordsLinked to original sources
PubMed1995

Dorsal ramus irritation associated with recurrent low back pain and its relief with local anesthetic or training therapy.

Nerves leave the spinal cord as mainly motor primary rootlets and sensory rootlets. These join to nerve root before leaving the spinal canal. After the root canal, the nerve root branches into the ventral root, which contains sensory and motor fibers innervating the extremities, and the dorsal root, that is, the dorsal ramus, which innervates the posterior structures, for example, back muscles: the dorsal ramus itself may become irritated (dorsal ramus syndrome). Especially predisposed to entrapment is the medial branch of the dorsal ramus, which innervates the multifidus muscle and also contains pain fibers. Here we describe the influence of local anesthesia and back-muscle-training therapy on subjective and objective pain parameters in 21 low-back-pain patients who had similar clinical status and neurophysiologic findings and whose recurrent low back pain was most apparently associated with dorsal ramus neuropathy, without any radiologic or neurophysiologic evidence of more proximal ventral nerve root damage in the spinal cord or at the nerve root origin. After treatment, all were pain free and back muscle activity during lumbar-pelvic rhythm was normalized.

Adult↗
PubMed1993

Exercise therapy effects on functional radiographic findings and segmental electromyographic activity in lumbar spine instability.

Flexion-extension and traction-compression radiographs as well as functional electromyographic (EMG) analysis were used to assess nine patients with chronic low back pain and segmental instability symptoms. After a treatment program, at which time most of the patients were asymptomatic and their physical status normalized, the patients were reexamined using EMG and radiographs. No significant change was found in the functional radiographic examination, whereas the myographic findings were significantly improved. Although the number of subjects was small, the results suggest that radiographic findings correlate poorly with clinical findings. Because of the improvement of the physical and myographic findings, the term "segmental dysfunction" may better describe the disability and symptoms than does the term "segmental instability."

Adult↗
PubMed1992

Cervical rotation lateral flexion test in brachialgia.

The cervical rotation lateral flexion test (CRLF test), developed earlier, was used to examine patients with brachialgia and thoracic outlet syndrome (TOS) symptoms to detect possible restriction of the movement of the first rib. The test was performed for 23 patients, five of them both before and after treatment. The patients were assessed independently by two clinicians to analyze the interobserver reliability. A cineradiographic examination was performed so that any restriction of the movement of the first rib during expiration and inspiration could be detected objectively. The interobserver repeatability of the test was excellent, thus making the cineradiographic examination unnecessary. It is recommended that this test be included in the clinical investigation of all patients with brachialgia with or without radicular pain.

Adult↗
PubMed1991

Recurrent thoracic outlet syndrome after first rib resection.

Seventy-seven patients with 84 operated limbs participated in a follow-up examination on an average of about six years after the resection of the first rib for thoracic outlet syndrome (TOS). Forty-two limbs (50%) were totally asymptomatic one month after the operation and remained so for at least half a year postoperatively. In the follow-up examination, 31 limbs were still asymptomatic, whereas 11 limbs had the same symptoms as before the operation. Of the nine patients with recurrent TOS (two with bilateral resection), seven were women and two were men. These nine patients were on average 38 years old (range = 19 to 51 years) and their jobs consisted of monotonous desk work. Seven of 11 stumps of the first rib were subluxated disclosed by the cervical rotation-lateral-flexion test. The occurrence of a subluxated stump of the first rib in the group of asymptomatic patients was far lower, only 3% (p less than .001). Of the 42 patients with persistent problems, a subluxated stump was encountered in seven (17%). Results of this follow-up examination suggest that monotonous desk work is an important factor causing kinesiologic abnormalities in the thoracic aperture. This abnormal kinesiology contributes to the recurrence of TOS symptoms even after the resection of the first rib.

Adult↗
PubMed1990

Cervical spine rotation and lateral flexion combined motion in the examination of the thoracic outlet.

The axial rotation and simultaneous lateral flexion of the cervical spine is kinesiologically related to the movements of the upper thoracic spine. Five brachialgia patients were found to have a hypomobile first rib on the painful side in a cineradiographic study. The kinesiologic finding was the following: when the neutrally positioned cervical spine was first maximally rotated passively away from the painful side, the passive lateral flexion was restricted in this position. This can be due to the first thoracic transverse process bumping against the subluxated first rib. This test of cervicothoracic mobility is useful in the examination of the thoracic outlet function.

Brachial Plexus Neuritis↗
PubMed1989

Long term outcome after resection of the first rib for thoracic outlet syndrome.

A total of 112 first ribs in 103 patients were resected over 11 years for thoracic outlet syndrome. Seventy-seven patients (84 operations) were followed up for 2.5 years or more to assess the long term results of this procedure and the factors affecting them. One month after surgery 52 per cent of limbs were asymptomatic and 77 per cent were at least improved. A follow-up examination was performed, on average 6.1 years after the operation, by two independent examiners. This evaluation showed a permanent success rate of 37 per cent among 84 limbs examined. These long term results compare unfavourably with previously published data. The reason for the poor final outcome seemed to be difficulty in selecting patients for the operation. This was not aided by any of the preoperative tests. Patients in this study were evaluated by independent examiners, and only a total absence of preceding symptoms was accepted as the criterion for success. We emphasize the importance of unbiased evaluation and long term follow-up.

Adult↗
PubMed1989

Cineradiography of the hypomobile first rib.

A patient with bilateral chronic brachialgia was cineradiographically shown to have hypomobile first ribs bilaterally. This finding can be elicited by the Expiration-Inspiration (E-I) test, in which the patient is palpated just beneath the clavicles while breathing. Right side scalenus muscle activation restored the movement of the right first rib. The cineradiography confirms the validity of the palpatory E-I test which has been previously described.

Cineradiography↗
PubMed1988

Subluxation of the first rib: a possible thoracic outlet syndrome mechanism.

Twenty-two cases of both the thoracic outlet syndrome (TOS) and reflex sympathetic dystrophy (RSD) are described, four in detail. Each case had a hypomobile first rib on the painful side. A simple test was used to evaluate the first rib mobility. After isometric exercises of the scalene muscles, the mobility of the first rib was restored and the symptoms completely relieved in 13 patients. We concluded that the subluxation of the first rib may irritate the neural network and the stellate ganglion in the neighborhood of the first costotransverse joint. This in turn can cause the radiating pain and RSD symptoms.

Adult↗
PubMed1982

Clinical stages of progressive myoclonus epilepsy in adult patients.

Nineteen hospitalized adult patients with progressive myoclonus epilepsy were studied. According to their clinical status they were divided into three groups of severity. The ages and duration of the disease did not differ significantly between the groups. The groups showed significant differences in ability of daily living, amount of spontaneous myoclonus, IQ and psychomotor reaction time. In EEG the groups differed in respect to the dominant occipital rhythm and amount of myoclonic spikes but not in respect to universal paroxysms. Myoclonic spikes and paroxysms in EEG were only loosely related. The results yield a conclusion that the deterioration caused by the disease is individual and the progression may even cease. In this respect progressive myoclonus epilepsy differs clearly from many hereditary neurometabolic and storage diseases.

Activities of Daily Living↗
PubMed1982

Progressive myoclonus epilepsy is not accompanied by humoral immune response within the central nervous system.

CSF and serum from five patients with progressive myoclonus epilepsy taken on two occasions with about one month's interval were examined for intrathecal humoral immune response. The CSF IgG and IgA index values were normal, and no oligoclonal bands were detectable by agarose electrophoresis or polyacrylamide isoelectric focusing (IEF). Immunofixation of IEF separated IgG with four different viruses as possible antigens, and autoradiography did not reveal any intrathecal antibody production. In contradiction to previous reports, no evidence was obtained for a local humoral immune response in progressive myoclonus epilepsy.

Adult↗
PubMed1982

Decrease of GABA in the cerebrospinal fluid of patients with progressive myoclonus epilepsy and its correlation with the decrease of 5HIAA and HVA.

The degenerative type of progressive myoclonus epilepsy (PME) is a hereditary disease with grand mal seizures, stimulus sensitive myoclonus, characteristic EEG and mental deterioration in the late stage. GABAergic antiepileptic drugs are the most effective ones in this disease, with an unknown etiology. In this study, the GABA concentration in the CSF of 15 PME patients was measured and compared with values of sex- and age-matched epileptic controls. It was correlated with the concentrations of 5HIAA and HVA in the CSF, which were determined earlier from the same patients. The GABA concentration in the PME patients was statistically significantly decreased, to about 75% of that of the epileptic controls. It correlated with HVA and 5HIAA concentrations in the PME patients, but not in the epileptic controls. It is unknown whether these findings are related to the primary cause of PME or whether they are only secondary, owing to a loss of respective neurons or synapses.

Adult↗
PubMed1982

Electroneuromyographical and morphological findings in progressive myoclonus epilepsy (PME).

The purpose of this study was to assess the function of peripheral nerves and muscles and to describe morphological changes in muscle biopsies of patients with progressive myoclonus epilepsy. Electroneuromyographic studies were performed on 24 adult patients whose mental and motor skills were either little, moderately or severely impaired by the disease. In 5 patients a specimen of tibial anterior muscle was morphologically and histochemically investigated. The electrophysiological functions of the peripheral nerves and muscles showed gradual increasing abnormalities parallel to the severity of clinical deterioration. The muscle biopsies of 2 patients showed signs compatible with peripheral neuropathy. These findings suggested that progressive myoclonus epilepsy may be related to a systemic membrane disorder.

Adolescent↗
PubMed1981

Electrophysiological signs of peripheral nerve dysfunction in progressive myoclonus epilepsy.

Electrophysiological findings were analysed in a group of 24 patients with progressive myoclonus epilepsy (PME) without Lafora bodies. Denervation activity in needle EMG and diminution of motor and sensory responses pointed out a mild axonal degeneration. We observed a significant slowing of motor and sensory conduction velocities in all the limb nerves examined, but distal motor latencies were not significantly increased. H-reflex latency of the posterior tibial nerve was prolonged. These results yielded the suggestion that there is a systemic peripheral nerve membrane dysfunction in PME.

Adolescent↗